What You Need to Know   Attention Argus WEST VIRGINIA Network Pharmacies:   The MCO (Managed Care Organizations for Medicaid) requires that you have the option to be notified in advance of changes to the generic pricing utilized for West Virginia Family Health beneficiaries.  Later this fall, we will be implementing enhancements to our Argus Pharmacy Portal which will allow you to subscribe to an alert system which will notify you when changes to the MAC pricing are being made.  When that enhancement is completed, we will send another bulletin with instructions on how to register for those alerts.   In the interim, we will be emailing the MAC changes to you at this email address.  If you wish to OPT OUT, please reply to the email notification and add “OPT OUT” to the subject line before sending.  We will gladly remove you from our distribution list. Action Required If you have any questions, please feel free to reach out to our MAC team via email to macinquiries@argushealth.com

Sent in conjunction with MIPA     Medicaid Provider Notice MS Division of Medicaid has activated pharmacy billing procedures in times of officially declared emergencies During states of officially declared emergencies, DOM has a new pharmacy point of sale (POS) procedure. As of the time of this email, this has been activated. At the time of this email, Benton, Marshall, Panola, Prentiss, Quitman, and Tippah counties have been declared as official emergency counties. Pharmacists should enter a value of ’13-Payor Recognized Emergency’ in NCPDP Field ‘420-DK’ when it is necessary to override the following service limit edits: • 2 Brand/5 Prescription Limit • Early Refill Please note that when the declared emergency announcement is made, the fields noted above will be opened for the specified time period. Pharmacy providers are advised to use professional judgment in emergency situations. The Division of Medicaid may conduct audits after such events to ensure appropriate care was taken in dispensing medications for affected beneficiaries. Providers and beneficiaries residing and/or receiving care not in an evacuation and/or disaster area must have documentation on file to justify rationale for early/excess fills. Medicaid monies may be recouped if supporting documentation is not found.

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Beginning Jan. 1, 2016, the Member Identification Number, Bank Identification Number (BIN), Processor Control Number (PCN) and Group (GRP) codes will change for UnitedHealthcare Care Improvement Plus Medicare Part D members. Please submit all UnitedHealthcare Care Improvement Plus Medicare Part D pharmacy claims and include the BIN, PCN and GRP code. This helps ensure the pharmacy claim applies to the correct member account and benefit information. BIN, PCN and GRP information is listed on the front of the UnitedHealthcare Medicare member identification (ID) cards.

OptumRx will assume responsibility for claims processing for members of Packers Sanitation Services, Inc. Please Note:  All plan participants of Packers Sanitation Services, Inc will receive a new member identification (ID) card. Please refer to the sample of the new ID card below.  Prescriptions need to be processed on-line using the Packers Sanitation Services, Inc ID card information.